Individual provider Active NPI

Kimberly Zeender Christy, RD, LD, CLC

  • Registered Dietitian
  • Ashtabula, OH
National Provider Identifier
1023589678
Registry record updated Jun 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
LD.7181 Issued in OH
Practice address
4200 State Rd
Ashtabula, OH 44004-6017
Phone
(440) 998-7515
Fax
(440) 998-0973
NPI assigned
Dec 7, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 1030543 IL
Registered Dietitian 133V00000X LD.7181 OH Primary

Addresses

Primary practice location

4200 State Rd
Ashtabula, OH 44004-6017

Mailing address

4200 State Rd
Ashtabula, OH 44004-6017
Phone (440) 998-7515

Other identifiers 1

IdentifierTypeStateIssuer
331707MedicaidOH

Other names 1

  • Kimberly Zeender Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1030543ILMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Ashtabula County Community Action Agency Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1544140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623110400000",
    "number": "1023589678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 STATE RD",
            "city": "ASHTABULA",
            "state": "OH",
            "postal_code": "440046017",
            "telephone_number": "440-998-7515",
            "fax_number": "440-998-0973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 STATE RD",
            "city": "ASHTABULA",
            "state": "OH",
            "postal_code": "440046017",
            "telephone_number": "440-998-7515",
            "fax_number": "440-998-0973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZEENDER CHRISTY",
        "first_name": "KIMBERLY",
        "credential": "RD, LD, CLC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-07",
        "last_updated": "2021-06-08",
        "certification_date": "2021-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "1030543",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OH",
            "license": "LD.7181",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "331707",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "ZEENDER",
            "credential": "RD, LD, CLC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Ashtabula, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.